Excess mortality of hepatocellular carcinoma and morbidity of liver cirrhosis and hepatitis in HCV‐endemic areas in an HBV‐endemic country: Geographic variations among 502 villages in southern Taiwan

Tsai, Meng-Chin; Kee, Kwong‐Ming; Chen, Yao-Der; Lin, Luke; Tsai, Lin-San; Chen, Chien-Jen; Lu, Sheng–Nan

doi:10.1111/j.1440-1746.2006.04489.x

Cited by 63 publications

(73 citation statements)

References 36 publications

(47 reference statements)

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“…Our previous case-control study found that chronic HCV infection was the major cause of excess mortality from HCC in an HBV-HCV endemic area [11]. The same finding was shown later in a large-scale community-based survey [7]. The predominant etiology of male HCC was HBV.…”

Section: Discussionsupporting

confidence: 57%

“…This finding correlated well with several high-incidence HCV infection areas in Taiwan reported in previous smaller studies. This was especially true in southern Taiwan [7,11,12]. It is interesting to note that some significantly low prevalence townships still exist in these high-incidence HCV prevalent counties.…”

Section: Discussionmentioning

confidence: 99%

“…The major viral etiology in male Taiwanese HCC patients is HBV [1,6]. We have shown in an earlier study that HBsAg prevalence is more closely correlated with HCC mortality than anti-HCV prevalence among male subjects [7]. Hence, those areas having higher HCV-related male HCC patients could potentially be HCV endemic areas.…”

Section: Introductionmentioning

confidence: 99%

“…The methods of patient enrollment and items recorded have been reported elsewhere [6,7]. Eight medical centers participated in this study.…”

Section: Patients and Data Collectionmentioning

confidence: 99%

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Geographic variations of predominantly hepatitis C virus associated male hepatocellular carcinoma townships in Taiwan: identification of potential high HCV endemic areas

Chen

Lin

et al. 2009

Hepatol Int

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Purpose The proportion of B-HCC cases in Taiwan has progressively decreased over the last 20 years. It was not really due to an overall decrease in B-HCC but due to an increase in HCV-related HCC. The identification of potential HCV endemic areas in Taiwan has consequently become important. Methods Data were collected retrospectively from eight Taiwan medical centers from 1981 to 2001, the geographical variations of male C-HCC townships in Taiwan were illustrated on maps. Goodness of fit was used to compare the anti-HCV prevalence in townships and cities, with the mean anti-HCV prevalence for Taiwan as a whole. Township-, city-, and county-specific prevalence of anti-HCV was presented as the median, ranges, and SMRs. 123Hepatol Int (2009( ) 3:537-543 DOI 10.1007 Results Geographic variation can be analyzed in only 263 townships and cities. The maps were designed on the basis of different SMRs. The mean anti-HCV prevalence for male HCC patients in Taiwan was 31.9% (95% confidence interval: 30.7-33.0). Twenty-five townships distributed throughout central-western and south-western Taiwan have significantly higher prevalence (P \ 0.05) (12 townships SMR C 2; 13 townships 1.5 B SMR \ 2). Twenty-two townships have significantly lower prevalence (P \ 0.05) (6 townships 0.5 B SMR\1; 16 townships SMR \ 0.5). Four different patterns of geographic variation in different counties were also noted and demonstrated. Conclusion We successfully highlighted some potential high HCV endemic townships in Taiwan.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The methods of patient enrollment and items recorded have been reported elsewhere [6,7]. Eight medical centers participated in this study.…”

Section: Patients and Data Collectionmentioning

confidence: 99%

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Geographic variations of predominantly hepatitis C virus associated male hepatocellular carcinoma townships in Taiwan: identification of potential high HCV endemic areas

Chen

Lin

et al. 2009

Hepatol Int

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“…35 Results from another large-scale community study also indicated an association between the prevalence of anti-HCV and hypertransaminemia, thrombocytopenia, and HCC. 36 Although we limited to our study to patients with thrombocytopenia or cirrhosis, the positive predictive values of AFP and US in this study were only 23.3% and 59.5%, respectively, in the second stage of screening. These findings are compatible with findings from previous studies.…”

Section: Discussionmentioning

confidence: 99%

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high‐risk for hepatocellular carcinoma

Wang

Liu

et al. 2006

Cancer

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BACKGROUND.The objective of this study was to examine the usefulness of platelet counts in the diagnosis of cirrhosis and for identifying high‐risk individuals in a community‐based hepatocellular carcinoma (HCC) screening program.METHODS.Pilot Study 1 determined the correlation between platelet counts and pathologic hepatic fibrosis scores among individuals with chronic hepatitis B virus (HBV) infection (n = 122 patients) and hepatitis C virus (HCV) infection (n = 244 patients). Pilot Study 2 investigated proportions of individuals with thrombocytopenia (<150 × 103/mm3) among patients with HCC (n = 4042 patients). Pilot Study 3 demonstrated the correlation between platelet counts and ultrasonographic (US) parenchyma scores among anti‐HCV‐positive individuals (n = 75 patients). The core study was a 2‐stage, community‐based screening for HCC among residents age 40 years or older in townships with a high prevalence of anti‐HCV (n = 4616 individuals) and in townships with a low prevalence of anti‐HCV (n = 1694 individuals). Patients with thrombocytopenia were identified for US and α‐fetoprotein screening.RESULTS.Among the individuals who were positive for anti‐HCV, platelet counts decreased according to increased pathologic fibrosis scores or US scores for liver parenchyma disease: The best cutoff platelet count was 150 × 103/mm3 for a diagnosis of cirrhosis. The sensitivity and specificity were 68.2% and 76.4%, respectively, for pathologic cirrhosis and 76.2% and 87.8%, respectively, for US cirrhosis. Forty‐eight percent of patients with HCC were thrombocytopenic. The proportion of thrombocytopenia was significantly greater in patients with HCV‐related HCC (63%) than in patients with HBV‐related HCC (42%). In the townships with high and low anti‐HCV prevalence, the prevalence of thrombocytopenia was 17.9% and 6.1%, respectively, (P < .001), respectively. Twenty‐five patients were diagnosed with HCC, and all of those patients resided in the high‐prevalence township.CONCLUSIONS.Thrombocytopenia was a valid surrogate of cirrhosis and a valid marker for the identification of individuals at high‐risk for HCC, especially in areas that had a high prevalence of HCV. Cancer 2006. © 2006 American Cancer Society.

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Endemic hepatitis B and C virus areas are associated with lower prevalence of hyperlipidemia: Ecological and cross‐sectional studies

Chen¹,

Huang²,

Wang

et al. 2017

Adv in Digestive Medicine

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Summary Backgrounds Patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection have been documented to have lower levels of cholesterol and triglyceride. This study attempts to validate this correlation from ecological and cross‐sectional research in community. Methods A total of 56,336 subjects in 533 villages of Tainan County underwent health screening in 2004. The antibody to HCV (anti‐HCV), Hepatitis B surface antigen (HBsAg), total cholesterol and triglyceride levels were checked. We used village as a unit to analyze the correlations between prevalence of HBsAg or anti‐HCV and hypercholesterolemia or hypertriglyceridemia. Statistical analyses were simple linear regression and Student t test. Results Mean serum cholesterol and triglyceride levels were both significantly lower in subjects with HBV and HCV infection (all p < 0.001). Village‐specific prevalence rates of hypercholesterolemia (r = – 0.15) and hypertriglyceridemia (r = – 0.21) were negative correlated with prevalence of HBsAg significantly (all p < 0.001). Village‐specific prevalence rates of hypercholesterolemia (r = ‐ 0.323) and hypertriglyceridemia (r = ‐ 0.258) were also negative correlated with prevalence of anti‐HCV significantly (all p < 0.001). Conclusions In this community‐based study, endemic villages of HBV or HCV infection were associated with a lower prevalence of hypercholesterolemia and hypertriglyceridemia. Copyright © 2017, The Gastroenterological Society of Taiwan, The Digestive Endoscopy Society of Taiwan and Taiwan Association for the Study of the Liver.

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Excess mortality of hepatocellular carcinoma and morbidity of liver cirrhosis and hepatitis in HCV‐endemic areas in an HBV‐endemic country: Geographic variations among 502 villages in southern Taiwan

Abstract: Prevalence of anti-HCV showed significant correlations with prevalence of hypertransaminemia, thrombocytopenia and liver cancer mortality. The findings indicate excessive mortality due to HCC, and LC and hepatitis prevalence in HCV-endemic areas in Taiwan, an HBV-endemic country.

Cited by 63 publications

References 36 publications

Geographic variations of predominantly hepatitis C virus associated male hepatocellular carcinoma townships in Taiwan: identification of potential high HCV endemic areas

Geographic variations of predominantly hepatitis C virus associated male hepatocellular carcinoma townships in Taiwan: identification of potential high HCV endemic areas

Thrombocytopenia as a surrogate for cirrhosis and a marker for the identification of patients at high‐risk for hepatocellular carcinoma

Endemic hepatitis B and C virus areas are associated with lower prevalence of hyperlipidemia: Ecological and cross‐sectional studies

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